Genicular Artery Embolization: A New Tool for the Management of Refractory Osteoarthritis-Related Knee Pain.
Marco FemiaCarlo Valenti PittinoEnrico Maria FumarolaMarco TramarinMaurizio PapaFrancesco GiurazzaAntonio Pio FranciosoDavide FiorLorenzo Paolo MoramarcoGuido AntoniniRuggero VercelliMaurizio CariatiPublished in: Journal of personalized medicine (2024)
Osteoarthritis (OA) of the knee is a prevalent cause of chronic pain and disability, particularly affecting women. While traditionally attributed to chronic wear and tear, recent evidence highlights multifactorial pathogenesis involving low-grade inflammation and neoangiogenesis. Current therapeutic options include physical therapy, pharmacotherapy, and total knee arthroplasty (TKA). However, a subset of patients remain symptomatic despite conservative measures, necessitating the development of minimally invasive interventions. Genicular artery embolization (GAE) emerges as a promising option, targeting neovascularization and inflammatory processes in OA. This paper reviews the pathophysiological basis, patient selection criteria, procedural details, and outcomes of GAE. Notably, GAE demonstrates efficacy in relieving knee pain and improving function in patients refractory to conventional therapy. While further research is warranted to elucidate its long-term outcomes and compare it with existing modalities, GAE represents a novel approach in the management of symptomatic knee OA, potentially delaying or obviating the need for surgical intervention. Here, we synthesize the relevant literature, technical details of the procedure, and future perspectives. Moreover, the success of GAE prompts the exploration of transarterial embolization in other musculoskeletal conditions, underscoring the evolving role of interventional radiology in personalized pain management strategies.
Keyphrases
- total knee arthroplasty
- chronic pain
- pain management
- knee osteoarthritis
- low grade
- total hip
- minimally invasive
- end stage renal disease
- radiofrequency ablation
- rheumatoid arthritis
- systematic review
- ejection fraction
- high grade
- randomized controlled trial
- oxidative stress
- newly diagnosed
- chronic kidney disease
- physical activity
- pregnant women
- prognostic factors
- peritoneal dialysis
- anterior cruciate ligament
- anterior cruciate ligament reconstruction
- adipose tissue
- drug induced
- robot assisted
- smoking cessation
- mesenchymal stem cells
- vascular endothelial growth factor
- replacement therapy
- glycemic control
- optical coherence tomography